Graphical user interface for display of anatomical information

ABSTRACT

A computer-aided diagnostic method and system provide image annotation information that can include an assessment of the probability, likelihood or predictive value of detected or identified suspected abnormalities as an additional aid to the radiologist. More specifically, probability values, in numerical form and/or analog form, are added to the locational markers of the detected and suspected abnormalities. The task of a physician using such a system as disclosed is believed to be made easier by displaying markers representing different regions of interest.

CROSS REFERENCE TO RELATED APPLICATIONS

The present application claims priority to the U.S. ProvisionalApplication Ser. No. 60/314,582 filed Aug. 24, 2001, and claims priorityto U.S. Provisional Application Ser. No. 60/252,743, filed Nov. 22,2000.

FIELD OF THE INVENTION

This relates to a system for rendering anatomical information. It isparticularly useful in the display of computer tomographic informationand will be described in that context.

BACKGROUND OF THE INVENTION

In conventional x-ray systems, a beam of x-rays is directed through anobject such as the human body onto a flat x-ray photographic film. Thebeam of x-rays is selectively absorbed by structures within the object,such as bones within the human body. Since the exposure of the x-rayfilm varies directly with the transmission of x-rays through the body(and varies inversely with the absorption of x-rays), the image that isproduced provides an accurate indication of any structures within theobject that absorbed the x-rays. As a result, x-rays have been widelyused for non-invasive examination of the interior of objects and havebeen especially useful in the practice of medicine.

Unfortunately, conventional x-ray systems have their limitations. Theimage that is formed from the x-ray is basically the shadow of thestructures within the object that absorb the x-rays. As a result, theimage formed on the x-ray is only two-dimensional, and if multiple x-rayabsorbing structures lie in the same shadow, information about some ofthese structures is likely to be obscured. Moreover, in the case ofmedical applications, it is often quite difficult to use conventionalx-ray systems to examine portions of the body such as the lungs thatconsist mostly of air when inflated and do not absorb x-rayssignificantly.

Many of the limitations of conventional x-ray systems are avoided byx-ray computer tomography, which is often referred to as CT. Inparticular, CT provides three-dimensional views and the imaging ofstructures and features that are unlikely to be seen very well in aconventional x-ray.

A typical CT apparatus 100 for medical applications is shown in FIG. 1.This apparatus includes a computer 110, a large toroidal structure 120and a platform 130 that is movable along a longitudinal axis 140 throughthe center of the toroidal structure. Mounted within the toroidalstructure are an x-ray source (not shown) and an array of x-raydetectors (not shown). The x-ray source is aimed substantially at thelongitudinal axis and is movable around the interior of the toroidalstructure in a plane that is substantially perpendicular to thelongitudinal axis. The x-ray detectors are mounted all around thetoroidal structure in substantially the same plane as the x-ray sourceand are aimed at the longitudinal axis. To obtain a CT x-ray image, apatient is placed on the platform and the platform is inserted into thecenter of the toroidal structure. The x-ray source then rotates aroundthe patient continuously emitting x-rays and the detectors sense thex-ray radiation that passes through the patient. Since the detectors arein the same plane as the x-ray source, the signals they receive relateessentially to a slice through the patient's body where the plane of thex-ray source and detectors intersect the body. The signals from thex-ray detectors are then processed by the computer to generate an imageof this slice known in the art as an axial section. Examples of CT axialsections of the thorax are shown in FIGS. 11A-11G.

How this image is generated will be more readily apparent from thesimplified explanation of FIG. 2. For purposes of illustration we willconsider x-rays emitted from only three points 252, 254, 256 within atoroidal structure 220 in a plane coincident with the plane of thedrawing. A platform 240 is movable along an axis 230 perpendicular tothe plane of the drawing. Each of points 252, 254, 256 is located on thetoroidal structure approximately 120° of arc from the other two pointsand the beam of x-rays diverges toward the axis 230. An array of x-raydetectors 260 extends around the toroidal structure in the same plane asthe x-ray source. If we assume that there is an object on the platformthat has an x-ray absorbing feature 270, we can see from FIG. 2 how thisfeature can be detected and located. The detector array will detect theshadow cast by feature 270 in portions 252A, 254A, and 256A of thex-rays emitted from sources 252, 254 and 256, respectively. However, itwill also detect that there was no absorption in regions 252 B&C, 254B&C and 256 B&C. The failure to detect absorption in regions 252 B&Cindicates that the dimension of the feature 270 along the line extendingfrom source 256 to the detectors in the region 256A is simply theprojection of region 252A onto that line. Similarly, the dimensions ofthe feature along the lines from source 252 to region 252A and fromsource 254 to region 254A can be determined. And from these calculationsthe shape and location of feature 270 can be determined.

In practice, x-rays are emitted continuously for the full 360° aroundthe patient and numerous features are observed but the overall approachis generally the same.

While the patient remains motionless, the platform is moved along thelongitudinal axis through the toroidal structure. In the course of thismovement, x-ray exposures are continuously made of the portion of thepatient on which CT is to be performed. Since the table is moving duringthis process, the different x-ray exposures are exposures of differentslices of the portion of the patient being examined and the imagesgenerated by the computer are a series of axial sections depicting inthree dimensions the portion of the patient's body that is beingexamined. The spacing between adjacent CT sections depends on theminimum size of the features to be detected. For detection at thehighest resolution, center-to-center spacing between adjacent sectionsshould be on the order of less than 2 mm.

Because of the superior imaging capabilities of CT, the use of CT inmedical imaging has grown rapidly in the last several years due to theemergence of multi-slice CT. However, the cost of conventional CTequipment remains quite high (an average selling price in the UnitedStates of $800,000 per unit) and the cost per patient far exceeds thecost of a conventional x-ray.

One application of medical CT is detection and confirmation of cancer.Unfortunately, in all too many cases, this application is merely toconfirm the worst. By the time a patient has symptoms enough thatwarrant the use of CT, the cancer detected by CT has progressed to thepoint that the patient is almost certain to die of the cancer.

The diagnostically superior information now available in CT axialsections, especially that provided by multidetector CT (multiple slicesacquired per single rotation of the gantry) where acquisition speed andvolumetric resolution provide exquisite diagnostic value, however,enables the detection of potential cancers at the earliest and mosttreatable stage. For example, the minimum detectable size of apotentially cancerous nodule in an axial section of the lung is about 2mm ( 1/10 of inch), a size that is potentially treatable and curable ifdetected. To intercept a developing cancer in the time between the pointat which it first becomes detectable and treatable and the time when ithas grown to the point where it is no longer treatable or treatment ispointless; it may become necessary to screen the population at risk on aregular basis. Presently, the standard of care is to find all cancer andpotential cancers at their earliest indication. Finding a cost effectiveway to screen the population for lung cancer remains challenging.

While costs/benefits are such that it is prohibitive to screen theentire population for cancer, there are sub-populations that are atgreater risk for cancer than others. One such population is that ofpresent or former smokers. Other such populations are those withoccupational exposures to known or suspected carcinogens. For thesepopulations the cost/benefit ratio is such that the use of CT forscreening purposes may well be warranted.

Tools that enhance the diagnostic value of the CT scans as well asenable the diagnostic determination by a radiologist in an economicallyreasonable time are required to assist the physician in the effort todetect cancer at its earliest and most curable stage. These tools arerequired whether the original examination was performed as a screeningor non-screening study.

SUMMARY OF THE INVENTION

The present invention is a system for displaying anatomical informationautomatically detected by computer algorithms (computer-aided detection,or CAD), such anatomical information generated by tomographic scanningof the body (i.e., CT, MRI, ultrasound, PET). The CAD system providesfor the display of detected objects in any selected viewport.

In a preferred embodiment, the system is responsive to system userinputs in various display portions of a user interface. For example, oneportion of an interface renders, or displays, a sequence of tomographicsections, the particular section or sections being displayed at any timebeing selectable by a scroll bar or scroll buttons. An additionalportion of the interface display renders a volumetric view of a bodyincluding an indication on the view of a position on the bodycorresponding to the tomographic section then being rendered, ordisplayed, on the first portion of the display. An additional portion ofthe display renders a volumetric view of a selected feature shown in thesection then being rendered, or displayed, on the first portion of thedisplay. The portions are designed to optimize the speed and accuracywith which the end user can diagnose the case. Optimization results fromthe mapping of the volumetric information, inherent to understanding thestructure and function of a region under review, to the normaltwo-dimensional, axial reading paradigm currently used by theradiologists reviewing these types of case sets. Also inherent to thisoptimization is that an automatically-detected portion of the system ismapped in all portion views.

The invention also includes the method of providing such a graphicaluser interface.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other objects, features and advantages of the invention willbe more readily apparent from the following Detailed Description of theInvention in which:

FIG. 1 is an illustration of a conventional CT system;

FIG. 2 is a sketch useful in understanding the operation of a CT system;

FIG. 3 is a block diagram of a conventional computer system on which theinvention may be practiced;

FIG. 4 is a sketch illustrating the operation of a mouse or trackball;

FIG. 5 is an illustration of a computer display of a preferredembodiment of the invention;

FIGS. 6, 7 and 8 are illustrations of menus that are displayed uponclicking first, second and third buttons on the display of FIG. 5;

FIG. 9A is an illustration of a magnification feature that is displayedupon clicking a fourth button on the display of FIG. 5;

FIG. 9B is an illustration of a measurement feature that is activatedupon clicking a fifth button on the display of FIG. 5;

FIG. 9C is an illustration of the thick slice feature that is activatedupon clicking a sixth button on the display of FIG. 5;

FIG. 10 is a block diagram illustrating the processing of CT data foruse in the practice of the invention;

FIGS. 11A-11G are an illustrative series of CT sections that aredisplayed in a selected axial view (FIG. 5);

FIGS. 12A-12G are the same series of CT sections as in FIGS. 11A-11G butwith a potentially cancerous nodule marked in accordance with theinvention;

FIG. 13 is an illustrative view seen in a second portion of the displayof FIG. 5;

FIG. 14 is a sketch useful in understanding FIGS. 15A-15D;

FIGS. 15A-15D are an illustrative series of views seen in a thirdportion of the display of FIG. 5;

FIG. 16 is an illustrative view of a scrolling control for the displayof FIG. 5;

FIG. 17 is a block diagram illustrating the operation of a preferredembodiment of the invention to display CT data;

FIG. 18 is an illustration of a second computer display of the presentinvention that provides for display of temporal data;

FIG. 19 is an illustration of a computer display of the presentinvention that provides for display of temporal data;

FIG. 20 is an illustration of a computer display of the presentinvention that provides for display of temporal data with themagnification feature activated; and

FIG. 21 is an illustration of the report feature that is activated uponclicking a seventh button on the display of FIG. 5.

DETAILED DESCRIPTION OF THE INVENTION

FIG. 3 is a block diagram of an illustrative computer system 300 usefulin the practice of the invention. As shown, system 300 comprises aprocessor 310, a memory 320 and input/output interface 330. Theinput/output interface connects the processor to an input device (suchas keyboard 340, a trackball 350, a mouse 360 and/or any other devicecapable of communicating and/or processing commands and inputs to theprocessor) and a display monitor 370. Illustratively, the processor is a500 MHZ Intel Pentium III (Reg. TRANSCEIVER MODULE) dual microprocessor.

Memory 320 typically is a mixture of semiconductor random access memory(RAM), one or more hard disk drives and/or CD-ROM drives, perhaps afloppy drive, and one or more tape drives. Stored within memory 320 arean operating system, application programs and the data representative ofone or more series of CT (or other three-dimensional datasets like MRI,ultrasound, PET) sections of one or more patients. Each series of CTsections is referred to as a case. A complete case might have 200 ormore CT sections to provide a high resolution three-dimensionalrepresentation of a portion of the body as large as the thorax.Advantageously, several such cases are available in memory 320 and canbe selected by the physician for examination.

FIG. 4 is a diagram useful in understanding the operation of trackball350. The ball of the trackball is shown in cross-section in FIG. 4 ascircle 450. The trackball is rotatable in substantially any directionincluding about axes 452 and 453 that are perpendicular to each otherand in the plane of the drawing. The trackball engages at least twopick-up wheels 454 and 455 that rotate about axes 456 and 457,respectively, that are parallel to axes 452, 453, respectively. Thepick-up wheels separate the motion of the trackball into motion in twoperpendicular dimensions and convert this motion into electrical signalsproportional to such motion. Thus, if the trackball were to be rotatedabout axis 452, the motion of the trackball would cause motion of thepick-up wheel 454 and that motion would be converted to an electricsignal. Pick-up wheel 455 operates similarly with respect to motion ofthe trackball about axis 453. The operation of mouse 360 is similar.

FIG. 5 depicts an illustrative embodiment of a display 500 of thepresent invention as generated on display screen 370. Display 500includes: a first display 510 of CT sections, a second display 520 thatis a volumetric view of the volume encompassed by the CT sections, and athird display 530 that is a magnified and rotatable portion of part ofthe volume rendered in the second display. The display system generatesthe volumetric view from the series of two-dimensional CT sections of anorgan (or portion of the human anatomy) displayable in the firstdisplay. In the embodiment illustrated in FIG. 5, the volumetricdisplays 520, 530 display the structure of the vessels shown in theaxial CT sections. Display 520 is a view of the entire regionencompassed by the CT sections while display 530 is a magnified androtatable portion of one small region. Display 520 makes it possible tovisualize the overall structure of the vessels. Display 530 helps thephysician establish whether a particular fleck is connected to a vesselor is isolated therefrom as in the case of the dot in the center ofdisplay 530.

The preferred display system provides for the display of any one or moreof the three display portions and enables the user to toggle on-off anyof the display portions. In the event any display portion is not shown,the remaining display portions may be re-sized. Accordingly, while FIG.5 depicts the rendering of images in three display portions, it will beunderstood that only one or two display portions may be displayed at theoption of the user.

Any type of digital or digitized image (CT, MRI, US, SPECT, PET) isamenable to the processing and rendering of images and views of anyorgan system. The tomographic sections to be processed, rendered,displayed or otherwise used includes tomographic sections acquiredthrough any plane, including, without limitation, saggital, coronal andaxial (or horizontal, transverse) planes and including planes at variousangles to the saggital, coronal or axial planes. While the disclosuremay refer to a particular plane or section, such as an axial section orplane, it is to be understood that any reference to a particular planeis not necessarily intended to be limited to that particular plane, asthe invention can apply to any plane or planar orientation.Additionally, the interface application disclosed herein enablesinteractive two-dimensional and three-dimensional rendering of an organor organ system (including, without limitation, lung, heart, brain,spinal, colon, liver and kidney systems) which enables user interactionwith the imagery. For illustrative purposes, a lung system is described.

In a preferred embodiment, the first display and second display arerelated to one another, for example, based on a common region ofinterest. As will be further discussed herein, one possibleimplementation of the inter-relationship of the first and second displayis for the second display to use a horizontal line as shown in FIG. 5 tohighlight on the volumetric view the relative location of a computer orphysician detected region of interest shown in the first display. Asvarious images are rendered in the first display, the location of thehorizontal line in the image in the second display will correspondinglychange in response thereto. The first display may also be responsive toinputs made in the second display. For example, in one approach theimage rendered in the first display can be a CT section selected bymoving a reference plane in the second display. The third display cansimilarly be linked to the first and/or second displays so that each ofthe first, second and/or third displays is related and is responsive toinputs received by any other display. For example, computer orphysician-detected regions of interest (possibly indicating a suspiciousnodule) selected in one display can be appropriately indicated in anyother display viewport. And, as shown in FIG. 5, the third displaydisplays a magnified and rotatable portion of part of the volumetricview depicted in the second display and associated with the CT sectionrendered in the first display. It is possible to provide suchinter-responsiveness among a first display, second display, thirddisplay and so on because the volumes and images rendered areconstructed and derived from the same sequence of axial sections.

In a preferred embodiment, the display also includes a lesion navigator540 (shown on the righthand side of FIG. 5) for selecting differentcomputer or physician detected regions of interest in the acquireddataset or selecting a particular nodule for display in another displayportion. Navigating, or scrolling, through the selector automaticallyupdates all axial and volumetric display viewports (or display portions)in which a computer or physician detected suspicious region of interestis located. For example, and explained further below in regards to FIG.16, the navigator can include scroll bars and/or buttons to facilitateselection of a desired CT section. A navigator can be configured tointeract with any of the first, second or third display portions ormultiple navigators can be employed, each associated with a display. Anavigator can include one or more identifiers associated with one ormore markers. Clicking or selecting an identifier causes display of theimage or CT section associated with the identifier, facilitating theselection and rendering of a desired image or CT section.

The CT sections display in a gray scale the regions of the body thathave absorbed x-rays. In FIG. 5, the CT section is a section of thethorax. The dark enclosed regions are the air-filled lungs. The whitestsections are bone with the spine being displayed in the bottom center ofthe section and the bones of the rib cage surrounding the lungs. Theremaining gray regions are muscle, fat and skin with the most prominentfeature being the globular mass of the heart. In the case of the grayregions, x-ray absorption is primarily attributable to the presence offluids in these regions.

Within the lungs are numerous gray flecks. For the most part, theseflecks are sections of blood vessels within the lung that have absorbedsufficient x-rays to be visible in the gray scale image. These vesselscan be identified by finding contiguously aligned flecks in adjacentaxial sections and following such structures through the axial CTsections long enough to establish that they are indeed sections of bloodvessels. Some flecks, however, may be cancerous nodules. These aregenerally recognizable by their globular shape and their isolation fromthe vesicular structures in the lung. Two such cancerous nodules areidentified by circles, such as circles 541 and 542, in display 510.

In the prior art, a physician scans through a series of axial CTsections relying on visual memory to establish the connectivity of thevesicular structures and looking for the isolated flecks that may besections of cancerous nodules. Typically, this type of scan is done in aminute or less. In view of the complexity of the structures present inthe axial sections, it can be appreciated that this is a difficult taskand one in which cancerous nodules can frequently be overlooked.

The display system can include markers or other graphic representationsto assist the user in examination of the displays; and the imagerendered in a first, second or third display can be controlled by theselection of a marker in a first, second or third display. For example,the second display may include one or more such markers highlighting andassociated with various regions of the volumetric view; and a CT sectionassociated with a marker selected in the second display may be renderedin the first display. Similarly, a rendering in the third display ispreferably responsive to the selection of a marker from the first orsecond display.

In a preferred embodiment of the invention, display 500 generates avariety of markers including highlighted markers 541, 542 and linesegments on scroll bar 540. Such markers identify potential regions ofinterest as determined by image processing steps performed, for example,by processor unit 310 and are intended to direct the attention ofqualified personnel to suspicious areas. In one preferred embodiment,the digital image in the first display, second display and/or thirddisplay will have marker(s) or other identifiers such as an asterisk(*), triangle or configurable circles (shown as 541, 542) superimposedon those locations corresponding to suspicious regions, detectedautomatically by computer or by the physician, and other markers oridentifiers superimposed on other regions of interest wherein such othermarkers or identifiers are preferably visually different (e.g.,different shape, size or color).

In the embodiment of the invention shown in FIG. 5, a first marker (e.g.541 or 542), in this case circular, is shown at the centroid of severalregions of interest on a digitized image in the first display.Concurrently, the second display preferably displays a second displaymarker, such as a horizontal line at a location of the bodycorresponding to the location associated with the first marker. A thirddisplay marker may appear in the third display. However, since the imagein the third display is an enlarged view associated with a region ofinterest, the third display marker preferably takes the form of ahighlighted nodule or region of interest displayed in a different color.

As an enhancement, further information may be provided by showing theevaluator exactly which pixels of the image are considered suspicious.For example, pixels of an image may be highlighted with a particularcolor, such as green or red, or shown white. In an embodiment of theinvention, the display device may include a touch screen. In such anembodiment, the evaluator can select to view an area surrounding somehighlighted pixels by simply touching the marker on the screen. Thesystem then provides a close up view of the region with the highlightedpixels. Alternatively, the display device may be a cathode ray tube(CRT) connected to an input device such as a keyboard or mouse, and theinput device may be used to command the system to provide a close upview and to highlight the suspicious pixels.

Experience has shown that there are situations where the furtherinformation provided by highlighted pixels is useful in reducing falsepositive indications sometimes called “false markers.” Computer-aideddetection codes use objective data which sometimes leads to these falsemarkers and a possible waste of time for the evaluator. Using thepresent invention, however, the evaluator's time is much better used. Byshowing the evaluator exactly which pixels the computer algorithmconsidered suspicious, and immediately available to the user in 2-Dand/or 3-D representations, she can more easily evaluate and dismissfalse markers. Furthermore, the present invention allows the evaluatorto more readily evaluate true markers corresponding to potentiallymalignant nodules.

Display 500 further includes an array 500 of software-controlledfunction buttons that is configurable by the user and typically includesmost of the following: a load studies button 551, a window level button552, a magnify glass button 553, a measurement button 554, a thick slicebutton 555, a nodule on button 556, a reset button 557 and an exitbutton 558. Additional buttons can be located on button tab 560 such asschedule button 561, review button 562 and reports button 563. Display500 can be configured to have button functionality located in variouslocations, either as part of a tab display, such as button tab 560, oras part of array 550 of function buttons.

The load studies button allows a user to select and load a particularcase into the system for viewing. The particular case information mayinclude, without limitation, the patient's name, patient history,detailed patient information or other information related to a testprocedure or diagnosis. Upon clicking on this button, a menu isdisplayed such as that depicted in FIG. 6. The menu has a file namedisplay 610, a folder display 620, a file type display 630, and a drivesdisplay 640. The file name display may be scrolled by a scroll bar 612and up and down buttons 614 and 616. Similarly, the folder display maybe scrolled by scroll bar 622 and up and down buttons 624 and 626. Thefile type display and the drives display may be scrolled by down buttons636 and 646, respectively.

The drives display 640 allows the user to select a particular hard driveor floppy drive on which is located the data of interest. The folderdisplay 620 displays the folders that are stored on the selected driveand allows the user to select the particular folder in which is locatedthe data of interest. The file name display 610 displays the files (orcases) that are stored in a particular folder and allows the user toselect one of these cases for display on display 370. File type display630 allows the user to filter the files available in a folder.

The window level button 552 allows the user to change the brightnesslevel and contrast level of the display. Clicking on this buttonactivates the left button of the mouse. While the left button isdepressed, the mouse or trackball can be moved in one direction so as tochange the brightness level and in an orthogonal direction to change thecontrast level.

Clicking on the magnify glass button 553 activates the left button ofthe mouse. While the left button is depressed, the computer magnifiesthe display where a mouse-controlled cursor is located as shown in FIG.9A. By moving the mouse and thereby moving the cursor, the user canchange the portion of the display that is magnified. Advantageously, theamount of magnification can be selected by the user and is in the rangeof approximately 2× to 5×. The region that is magnified is displayed inbox 910. In one embodiment, the magnification box is set at apre-determined size with the box having a center corresponding to thelocation of the cursor. In an alternative preferred embodiment, the boxsize is configurable and based on a region of magnification defined by arectangle formed by locating the cursor at one corner andclicking-and-dragging the cursor to an opposite corner to define thesize of the image in the rectangle to be magnified. If the image in thebox 910 contains a nodule or object, such as nodule 920, the system canplace an outline 930 around the nodule. The outline is formed on thebasis of differing contrast levels between the bright nodule and thedark background. For example, if intensity at some reference point isØ₀, and at an adjacent point is Ø₁, the contrast can be defined as(Ø₁−Ø₀)/Ø₀. Contrast can also be expressed in terms of energy fluence orexposure. The outline allows for evaluation of the shape of the noduleand allows for detailed measurement of the nodule.

Upon clicking on the measurement button 554, the left mouse button isactivated. While the left mouse button is depressed, the computer systemwill display the radio opacity at the region of the CT section where thecursor is located. The measurement button can enable various otherfunctionality. For example, a measurement function can be activated by aclick-and-drag activation wherein the cursor can be placed in the firstdisplay 510, second display 520 or third display 530, and when the mouseis clicked and held, the cursor can be dragged within the display and ameasurement calculated representing the distance covered by the cursorwithin the display. Additionally, the measurement can be automated. Forexample, in the third display 530, measurement data such as nodulediameter, volume, average intensity level and maximum intensity levelcan be displayed as data 950 (FIG. 9B) for a selected or highlightednodule. The intensity level can be useful for determining whether aparticular nodule is calcified or whether calcification occurred.Preferably, intensity levels are based on computed tomography numbers(CT numbers) expressed in terms of Hounsfield units (HU). Measuredvalues of attenuation are transformed into CT numbers using theinternational Hounsfield scale:CT Number=(μ_(material)−μ_(water))/μ_(water)*1000  (HU)where μ is the effective linear attenuation coefficient for the x-raybeam. The CT number scale is defined so that water has a value of 0 HUand air a value of minus 1000 HU.

As another example, intensity levels can be displayed in the thirddisplay 530 for a selected region 940. The intensity levels for theselected region may be displayed in the form of a histogram. Histograminformation can be stored and used for statistical analysis forassessing whether calcification may be or has been occurring.

FIG. 9C depicts a representation when thick slice button 555 isactivated. Images in a first display are composed of data from thickerslices or from CT scanners having multiple detectors. Thicker slicesoffer the advantage that non-linear effects of volume averaging (such asstreaks) are reduced or eliminated as compared to conventional imagesformed at nominal slice thickness. Thicker slices offer fastercomputational and scanning times. Additionally, thicker slices areeffective for screening programs. For such applications as screening, ifthe interface highlights nodules or other areas of concern, a patientcan be re-scanned over the region of concern.

The nodule on button 556 toggles the nodule markers (e.g., white circlessuch as 541, 542, color coding or other devices to highlight individualnodules) on and off. Nodules can have circles of differing colorsrepresentative, for example, of whether a nodule has been considered,highlighted, or otherwise evaluated by a physician or other qualifiedpersonnel.

The reports button 563 captures the contents of the screen for directinput into a radiological report. Upon clicking on this button, the menuof FIG. 8 is displayed. This allows the user to select one of a varietyof output options into which he or she can move the image on thedisplay.

The reset button 557 resets all adjustments to the default values.

The exit button 558 terminates the program.

In one embodiment, a schedule button 561 provides a link to a pop-upwindow in which processing times can be scheduled. For example, in somecases it may be desirable to perform a CT scan but actually perform thenodule identification or other analysis at a later time. Delayingcertain analysis can save patient time in running tests. In this way,screening of many patients can be done more quickly. Additionally, byscheduling batch processing at a later time, the interface can reduce oreliminate the need for any complex or time-consuming real-time or nearreal-time processing, particularly during screening or in the event thescanning procedure is operated by an individual not qualified to performa diagnosis of the results. By storing pre-processed results from ascan, data can be processed at a later time. In this way, less patienttime is required. Additionally, storing pre-processed results allows forscheduling processing time during down time while making resultsavailable for the evaluator in a timely manner.

Not shown in FIG. 5 but advantageously included in the array of functionbuttons is a configuration button that allows a user to select a varietyof different display configurations. Upon clicking on the configurationbutton, a menu is displayed such as that depicted in FIG. 7. This menuincludes a display 710, a scroll bar 712, and up and down buttons 714and 716.

As shown in FIG. 7, display 710 allows selection of several differentformats and more are available by use of the scrolling capability. Theterms “3D-Right” and “3D-Left” allow the user to locate the second andthird displays 520, 530 on the right-hand and left-hand sides,respectively, of the entire display. The terms “2D-1X1,” “2D-1X2,”“2D-2X2,” “2D-2X3,” and “2D-3X3” allow the user to select a singleplanar section, two sections, four sections, six sections or ninesections for display in first display 510.

FIG. 10 is a block diagram illustrating the processing of CT for use inthe practice of the invention. At step 1010, conventional CT apparatusscans the portion of a patient's body. At step 1020, the signalsproduced from the detectors of the CT apparatus are processed togenerate CT planar sections. Illustratively, each section is identifiedby a slice number, a patient identification number and a time stamp. Atstep 1030, the planar sections are further processed to identify andmark suspicious regions on the planar sections. These regions arereferred to hereinafter as regions of interest (ROI). The regions aredetected using segmentation and image filtering algorithms similar tothose described in U.S. Pat. Nos. 6,014,452, 5,815,591 and 6,075,879assigned to R2 Technology, Inc. Where the CT sections are being examinedto detect lung cancer, the algorithms are optimized to locate nodulesbetween 2 and 20 mm. in the parenchymal regions of the lung, and assmall as 1 mm for small calcified nodules, calcification being adiagnostic indicator for benignancy. Advantageously, the sectionscontaining ROI are noted by slice number and a vector of slice numbersis generated identifying the section through the center of each ROI. Asdescribed below in conjunction with FIG. 16, this vector is used tonavigate through the display of ROI. Finally, at step 1040, the data isfurther processed to create a volumetric view of the region encompassedby the CT sections and to mark the location of the ROI on thisvolumetric view. At present, the processing depicted in FIG. 10 is doneoff-line on a computer different from that of the computer of FIG. 3 onwhich the axial and volumetric displays are generated.

FIGS. 11A-11G are an illustrative series of seven consecutive CT axialsections as they would be seen in the first display 510 with the nodulemarker toggled off. There is a potentially cancerous nodule in the upperleft quadrant of these sections. The difficulty of detecting the nodulewill be apparent.

FIGS. 12A-12G are the same series of seven consecutive CT axial sectionsbut now displayed with the nodule marker toggled on and a white circlecircumscribing the potentially cancerous nodule.

FIG. 13 is an enlarged view of the volumetric display in the seconddisplay 520. Each ROI in the CT sections is indicated by a circle at itscorresponding location in the volumetric display. The white horizontalline indicates the location in the volumetric display of the axialsection then being displayed in first display 510.

FIG. 14 is a sketch useful in understanding display 530. FIG. 14 depictsa horizontal plane 1410 and two vertical planes 1420 and 1430 at rightangles to each other. The X, Y and Z directions are as indicated. Theaxial sections of display 510 lie in the horizontal plane 1410. Inaccordance with the invention, trackball 350 or mouse 360 can be used torotate the viewpoint in display 530 about at least two axes, typicallythe vertical axis and one or both of the horizontal axes.

FIGS. 15A-15D depict four views of the same ROI at different rotations.The cancerous nodule is circumscribed by a white circle. As will beapparent, the ability to rotate the viewpoint makes it possible toestablish that the mass shown in the viewpoint of FIG. 15D as possiblyconnected to other structures is, in fact, isolated therefrom as shownin the viewpoints of FIGS. 15A-15C and therefore suspicious.

Advantageously, a set of reference symbols is provided in each displayto orient the user. The direction of view in FIG. 15D is the same asthat in display 520, that is, into the plane of the axial section. Thisis depicted in the reference symbol of FIG. 15D by showing the fullextension of the X coordinate in a horizontal line and the fullextension of the Z coordinate in the vertical direction. The directionof view in FIG. 15C is downward through the axial section with about 5°of clockwise rotation about the Z axis and a small amount of rotation ofthe axial section about the X axis. This is depicted in the referencesymbol of FIG. 15C by showing the X and Y coordinates as they would beseen looking down through the axial section with the Y coordinateshorter than the X coordinates and the X and Y coordinates rotated about5° clockwise. The direction of view of FIGS. 15A and B are upwardsthrough the axial sections. This is depicted in the reference symbols ofFIGS. 15A and 15B by showing the X and Y coordinates in the orientationthey would have if looking upward through the CT section. In FIGS. 15Aand 15B the views have also been rotated about the Z axis but inopposite directions. In addition, the views have been rotated about oneor both of the X and Y axes as suggested by the extension of the Zcoordinate.

Also displayed in the views of FIGS. 15A-15D are measurement data of thevolume and diameter of the ROI. Once the ROI is identified, the volumeof the ROI can be determined by the computer system by counting thevoxels in the ROI. The resulting volume is then converted to a diameterby assuming the volume is a sphere and using the standard formula forrelating the diameter of a sphere to its volume.

FIG. 16 is an enlarged view of navigator or scroll bar 540 of FIG. 5.The lesion or nodule navigator comprises a first set of up and downscroll buttons 1610, a display bar 1620, and a second set of left andright scroll buttons 1630. Display bar 1620 is a visual display of thevector of slice numbers that contain a ROI. Each slice number in thevector is represented in the display by a horizontal line. Thehorizontal line is an identifier of CT sections that are determined tocontain at least one nodule. The CT section then being displayed indisplay 510 is indicated by an identifier, such as white line 1622 inFIG. 16. The other CT sections are indicated by other identifiers, suchas dark lines 1624. The lines are spaced apart by an amount proportionalto their distance from each other in the complete case of CT sections.

The navigator scroll buttons 1610 enable the user to step the display ofCT sections in display 510 from one section containing a ROI to anothersection containing a different ROI. Specifically, with each click of anup or down scroll button 1610, display 510 goes from the display of a CTsection containing a ROI to the display of the CT section containing thenext ROI.

As indicated above, a horizontal line extends across volumetric display520 indicating the location of the axial section then being displayed indisplay 510. As the navigator scroll buttons 1610 change the CT sectionbeing displayed, the location of the white horizontal line 1622 ondisplay 1620 and the location of the white horizontal line on volumetricdisplay 520 change accordingly.

Likewise, the magnified view on display 530 changes to the ROIidentified on the selected CT section.

Left and right scroll buttons 1630 enable the user to navigate throughthe entire case of CT sections one-at-a-time. Each click of a buttonchanges the display to the next section in the case. These buttonsprovide more precise CT viewing around the identified ROI.Advantageously, a scroll bar (not shown) may also be provided to allowthe user to scan through the sections at a speed controlled by movementof the scroll bar.

FIG. 17 is a block diagram illustrating the operation of the computersystem 300 to display CT data in accordance with the invention. At step1710, the computer system scans the inputs to the system. These includethe status of the trackball 350 and mouse 360, the status of navigator540, and the status of the function buttons of array 550. Specifically,the white horizontal line 1622 determines the CT section to be displayedon display 510, the location of the horizontal line on display 520 andthe ROI displayed on display 530. The inputs from trackball 350 or mouse360 control the orientation of display 530 and inputs from the functionbuttons control the display of various menus and the execution of otheroperations.

Assuming that the operation to be performed is display of an CT section,the computer system displays the selected section at step 1720. It alsodisplays at step 1730 the volumetric view of display 520 with ahorizontal line indicating the position of the axial section; and itdisplays at step 1740 the view of the ROI on display 530 with anorientation specified by the inputs from the trackball or mouse.

FIG. 18 is a view of second embodiment of the display that provides forthe display of temporal information. The top portion of the display issimilar to that of FIG. 5. The bottom part provides on the right-handside a smaller view of the axial section immediately above it and a viewof a similar axial section taken at a previous time. On the left-handside, two magnified volumetric views are shown, one that corresponds tothe ROI identified on the CT section displayed in the upper right-handportion of the display and the other corresponding to the same ROI asimaged at a previous time. By presenting views taken at different times,the physician is able to assess any changes that have taken place in theROI. Volumetric change over time is an indicator of malignancy of anidentified nodule. At the bottom of the display is a series of functionbuttons similar to those of the display of FIG. 5.

FIG. 19 is a view of an alternative preferred embodiment of a displaythat provides for the display of temporal information. By presentingviews taken at different times, the physician is able to assess anychanges that have taken place in a ROI. The display has portionsassociated with scanning information from a current scan and a secondportion associated with scan results from a prior scan. For example, afirst portion can include a first display 1905 of CT axial sections, asecond display 1950 that is a volumetric view of the volume encompassedby the CT axial sections, a third display 1960 that is a magnified androtatable portion of part of the volume rendered in the second display,and a navigator 1910 for moving between different axial sections, andautomatically updating the volumetric sections for review as the axialsections are updated. The display in FIG. 19 also includes additionalportions depicting temporal images relating to scanned images of thepatient performed at a time different from that for the first portion: afirst temporal display 1925 of CT axial sections, a second temporaldisplay 1955 that is a volumetric view of the volume encompassed by theCT axial sections, a third temporal display 1965 that is a magnified androtatable portion of part of the volume rendered in the second displayand a navigator 1930 for moving between different axial sections, andautomatically updating the volumetric sections for review as the axialsections are updated. The display in FIG. 19 also may preferably includea registered scroll bar 1975 that allows for concurrent movement andscrolling of the images in the displays 1905 and 1925. At the bottom ofthe display is a series of function buttons 1970 that operate similar tothose of the display of FIG. 5.

Navigators 1910 and 1930 offer similar functionality to that of theother navigators described herein, for example, navigator 540. The firstnavigator preferably includes a first set of up and down scroll buttons1912 and 1914, and a second set of left and right scroll buttons 1916.Display bar 1911 is a visual display of the vector of slice numbers thatcontain a ROI. Each slice number is represented in the display by ahorizontal line such as horizontal line 1920. The axial section thenbeing displayed in display 1905 is indicated by a white line 1915. Theother horizontal lines are dark. The lines are spaced apart by an amountproportional to their distance from each other in the complete case ofaxial sections.

The second navigator preferably includes a first set of up and downscroll buttons 1932 and 1934, and a second set of left and right scrollbuttons 1936. Display bar 1931 is a visual display of the vector ofslice numbers that contain a ROI. Each slice number is represented inthe display by a horizontal line such as horizontal line 1940. The axialsection then being displayed in display 1905 is indicated by a whiteline 1942. The other horizontal lines are dark. The lines are spacedapart by an amount proportional to their distance from each other in thecomplete case of axial sections. Lines 1952 and 1957 correspond torelative volumetric locations in the images of second display 1950 andsecond temporal display 1955 of the axial sections as displayed in thefirst display 1905 and first temporal display 1930, respectively.

Each display window is independently controllable by navigator 1910 or1930. Alternatively, the images can be scrolled simultaneously vianavigation scroll bar 1975 which overrides the first and second set ofscroll bars to update images in the display windows concurrently andallows users to compare images in corresponding windows concurrently.

As will be apparent to one skilled in the art, the temporal displayimages can be extended to include images taken at a third or fourthtime, etc. so that qualified personnel would be able to track, monitorand/or diagnose a patient's progress over several different times.Corresponding scroll bars can be appropriately included.

While the temporal display images allow for a comparison of images takenof a patient at different times, in a further embodiment across-comparison display allows for the comparison of an image takenfrom a patient with an image of healthy tissue. In this way, the imagetaken of a patient can be easily compared against tissue representativeof a healthy anatomy for assessing whether the patient's image is one ofhealthy or unhealthy tissue. The comparison can be simply visual or thecomparison can be automated to determine whether the differences betweenthe patient's image and the related cross-patient image indicative ofhealthy tissue exceeds acceptable thresholds. For example, a doctor canplace one or more markers at a location on the patient image and place acorresponding marker at a location on the cross-comparison, or healthytissue image. Differences in dimensions or intensity levels may beindicated in a margin or generated in a report (see FIG. 21).

FIG. 20 is a view of the embodiment of FIG. 19 with the magnificationfeature activated via button 2010. FIG. 20 includes a first set ofimages associated with a first scan of a body. The first set of imagesis depicted in displays 2022, 2040 and 2042. FIG. 20 also includes asecond set of images associated with a second scan of a body taken at adifferent time (temporal images). The second set of images is depictedin displays 2032, 2050 and 2052. The display preferably include an array2060 of feature buttons. Preferably, the magnification feature isactivated at a location on an image in a display where the cursor isclicked. When clicked, a configurable magnification window is exposed atthe location. As shown in FIG. 20, the cursor can be clicked in thefirst display window 2022 to expose a first magnification window 2020.In the first magnification window, nodule outline 2025 is shown, similarto outline 940 described above. The outline is preferably formed on thebasis of differing contrast levels between the bright nodule and thedark background. If no nodule is in the magnification window, theoutline 2025 will not automatically appear. At the same time the firstmagnification window 2020 appears, the display of FIG. 20 is preferablyconfigured so that a second magnification window 2030 appears along withoutline 2035, if appropriate. The display of the second magnificationwindow 2030 about a nodule can be based on feature detection analysis ofthe nodule or other known features of the image in first magnificationwindow 2020 for a corresponding nodule or feature in the first temporalwindow. As can be seen from a comparison of displays 2040 and 2050, ahighlighted nodule may appear at different relative locations within thewindows over time. Lines 2045 and 2055 in displays 2040 and 2050,corresponding to the volumetric location of the images in displays 2022and 2032, respectively, are not necessarily at a same level within thedisplay. The nodule outlines allow for detailed measurements of nodulesize and for visual comparison of any changes of nodule shape or growththat may have taken place over time. Such visual comparisons facilitatediagnoses and/or the tracking of the effects of treatment.

FIG. 21 is a representation of a sample report that can be generatedwhen the report button is activated, such as button 559 or 1980. Thedisplay preferably includes a first display window 2110 for depicting avolumetric representation of scanned images, a report window 2120displaying selected information corresponding to various detected,selected or highlighted nodules and a notes window 2140 for inputtingcomments or notes related to the diagnosis. Report window 2120preferably displays in index column 2122 a list of nodules indexedagainst the slice number containing the nodule. The window alsopreferably displays reference coordinates in location column 2124 forcorresponding nodules in the index column, corresponding approximatenodule diameters in diameter column 2126, corresponding nodule volumesin volume column 2128, mean voxel intensity levels in column 2130 basedon a standardized scale and maximum voxel intensity levels in column2132 based on a standardized scale. Other columns can be added orremoved. For example, in the case where temporal images (images taken ofa body at different times) are being viewed, columns indicating nodulevolume and diameter change or percentage change over time can bedisplayed. In this way, the growth or reduction of individual nodulescan be tracked and monitored throughout treatment or diagnosis.Additionally, nodules can be selectively highlighted. For example,nodules above a preselected size can be highlighted. Moreover, the datain any column of a report is preferably sortable. The print reportbutton 2150 allows for a print out of a nodule report. Additionally oralternatively, a save button can be implemented to allow for saving ofthe nodule information on disk or other recording media. Button 2100allows the system to return to a prior display configuration.

Any of the display portions described herein can include numericalinformation within the display associated with any part of image thenbeing rendered. For example, the diameter, volume, and intensity valuescan represented for a selected nodule highlighted by a marker.Additionally, probability values, in numerical form and/or analog form,may be provided and associated with the markers for detected orsuspected abnormalities.

Preferably, the various interfaces are implemented based on touch-screentechnology. Touch screens may be activated by touch and may or may notnecessitate or include use of a mouse or other controller to navigatethe interface. For example, a standard resistive display can be usedwhere a controller and a specially-coated screen or glass overlayproduce a touch connection. Such resistive displays allow for access viavarious input tools such as a finger, gloved finger, stylus and/or pen.

Preferably, a capacitive touch screen is used. Capacitive touch screensare generally all glass and more durable. For such screens a smallcurrent of electricity runs across the screen, and touching the screeninterrupts the current and activates the screen. Such a screen is onlyactivated by a human finger; a gloved finger, stylus or pen will notusually activate the screen.

Yet other types of touch screens can be based on surface-acoustic-wave(SAW) technology. Such SAW-based screens use mechanical waves on thesurface of the glass to provide superior optical performance. When thescreen is touched by a finger, gloved finger, pen and/or stylus, amechanical wave is absorbed. Since a wave must be absorbed, SAW-basedscreens are resistant to false touch activations.

Medical applications also use infrared technology to implement high-endtouch screens. Such screens rely on the interruption of an infraredlight in the front of a display screen. Such screens can be sealed andactivated by a finger, gloved finger, pen or stylus.

Because medical imaging equipment typically must interoperate with othermedical devices, it is common for CT scanners and other medical imagingdevices, displays and software to be interoperable and exchange databased on a common standard or protocol. For example, one such protocolis the DICOM standard, published by National Electrical ManufacturersAssociation, 1300 N. 17th Street, Rosslyn, Va. 22209 USA. A currentfinal draft of this standard is publicly available athttp://medical.nema.org/dicom/2000.html. The DICOM standard includessyntax and semantics of commands and associated information which can beexchanged by devices, particularly medical imaging equipment using theprotocol. By using an interoperability standard, the exchange of digitalinformation between medical imaging equipment can be facilitated.Preferably, the various interfaces described herein are based on astandard such as the DICOM standard. Implementation based on a standardsupports the development of a conformance statement wherein a system isdefined and where interoperability can be expected with another deviceclaiming conformance to the standard. In this way, an interface can beconfigurable with various types and models of equipment conforming tothe standard.

In another embodiment, hard copy or printed images are producedresponsive to a command. Responsive to a command such as by touching atouch screen or by using another type of input device such as a keyboardor mouse, a high resolution image is printed using a printer. Theprinted image includes highlighting by applying a distinctive color suchas white or red to the identified pixels. Moreover, in an embodiment, aclose-up view is printed responsive to a command such that the printedradiographic image is shown at high resolution and the highlighting isalso shown at high resolution. A radiologist can then use the printedradiographic image to supplement his evaluation of the digitizedradiographic images as well as the actual radiographic films.

As will be apparent to those skilled in the art, numerous modificationsmay be made in the display of the present invention that are within thescope and spirit of the invention. While the invention has beendescribed in a particular context of CT scanning of the lungs to detectpotentially cancerous regions, the invention may also be used to displaythe results of CT scanning of other regions of the body and for otherapplications as well as to display the results of other scanningtechnologies such as ultrasound imaging and magnetic resonance imaging.For example, the invention described herein could apply other organs andanatomical parts including, without limitation, the heart, brain, spine,colon, kidney and liver.

1. A method for rendering anatomical information of a body fromtomographic data comprising the steps of: receiving said tomographicdata obtained from a digital imaging apparatus wherein said tomographicdata is displayable in a first portion of a display as one or moretwo-dimensional tomographic sections of a sequence of two-dimensionaltomographic sections; determining a third dimension from the sequence oftwo-dimensional tomographic sections to create a first volumetric viewwherein said first volumetric view is displayable in a second portion ofthe display; determining a second volumetric view of a selected featureshown in the first or second portion wherein said second volumetric viewis displayable in a third portion of the display; and rendering one ormore of said first, second or third portions of the display.
 2. Themethod of claim 1 further including the step of providing on-off togglewhereby any of the display portions can be toggled on to displayanatomical information or toggled off to remove from display thecorresponding display portion.
 3. The method of claim 2 furtherincluding the step of providing a scroll bar whenever the first displayis toggled on, for selecting the particular two-dimensional tomographicsection to be displayed in the first display portion.
 4. The method ofclaim 1 wherein the step of rendering further includes providing displaymarkers indicative of a region of interest in the body.
 5. The method ofclaim 1 wherein the step of rendering further includes providing displaymarkers indicative of a potentially cancerous nodule in the body.
 6. Themethod of claim 1 wherein anatomical information is rendered in thefirst and second portion of the display.
 7. The method of claim 6further comprising the step of updating the anatomical information inthe second display portion in response to a region of interest or animage rendered in the first portion of the display.
 8. The method ofclaim 6 further comprising the step of updating the anatomicalinformation in the first display portion in response to an imagerendered in the second portion of the display.
 9. The method of claim 1wherein anatomical information occurs in the first and third portions ofthe display.
 10. The method of claim 9 further comprising the step ofupdating the anatomical information in the first display portion inresponse to a region of interest or an image rendered in the thirdportion of the display.
 11. The method of claim 9 further comprising thestep of updating the anatomical information in the third display portionin response to an image rendered in the first portion of the display.12. The method of claim 1 wherein anatomical information occurs in thesecond and third portions of the display.
 13. The method of claim 12further comprising the step of updating the anatomical information inthe second display portion in response to a region of interest or animage rendered in the third portion of the display.
 14. The method ofclaim 12 further comprising the step of updating the anatomicalinformation in the third display portion in response to a region ofinterest or an image rendered in the second portion of the display. 15.The method of claim 1 wherein anatomical information occurs in thefirst, second and third portions of the display.
 16. The method of claim15 further comprising the step of updating the anatomical information ina display portion in response to the region of interest or the imagerendered in a different portion of the display.
 17. The method of claim15 further including the step of providing a scroll bar for selectingthe particular two-dimensional tomographic section to be displayed inthe first display portion.
 18. A system for rendering anatomicalinformation of a body from tomographic data obtained from a digitalimaging apparatus comprising: a first portion of a display for renderinga sequence of two-dimensional tomographic sections obtained from saidtomographic data; a second portion of the display for rendering a firstvolumetric view of the body wherein said first volumetric view isincludes a third dimension acquired from the sequence of two-dimensionaltomographic sections; and a third portion of the display for rendering asecond volumetric view of a selected feature shown in the section thenbeing rendered on the first portion or second portion of the display.19. The graphical user interface of claim 18 further comprising a fourthportion of the display for indicating the relative position of axialsections containing features of interest, said scroll buttons enabling auser to increment all displays (axial and volumetric) from one sectionto another.
 20. The system of claim 18 wherein the view of the thirdportion is rotatable by input from a trackball or cursor.
 21. The systemof claim 18 wherein the particular section being rendered at any time inthe first portion is selectable by means of a scroll bar or scrollbuttons.
 22. The system of claim 18 wherein the first portion of thedisplay includes at least one first display marker indicative of aregion of interest in the body.
 23. The system of claim 22 wherein atleast one second display marker is displayed in the second portion ofthe display at a location in the second portion of the displaycorresponding to the same location in the body as at least one firstdisplay marker.
 24. The system of claim 22 wherein the region ofinterest includes a potentially cancerous nodule.
 25. The system ofclaim 18 wherein said second portion includes an indication on saidvolumetric view of the position of the section then being rendered onthe first portion of the display.
 26. The system of claim 18 whereinsaid volumetric view of the third portion of the display is selectivelyrotatable so as to render information in the least one tomographicsection adjacent to the section then being rendered on the first portionof the display.
 27. The system of claim 18 wherein the first portion ofthe display includes at least one first display marker and wherein thesecond portion of the display includes at least one second displaymarker, said first display marker and said second display markercorresponding to the same location in the body.
 28. The system of claim27 wherein a first display marker is highlighted.
 29. The system ofclaim 28 wherein a second display marker is highlighted corresponding tothe same location in the body as identified by the highlighted firstdisplay marker.
 30. The system of claim 27 wherein the first displaymarker is responsive to the second display marker.
 31. The system ofclaim 27 wherein the second display marker is responsive to the firstdisplay marker.
 32. The system of claim 27 wherein the third portion ofthe display includes a third display marker corresponding to the samelocation in the body as highlighted by the first display marker or thesecond display marker.
 33. The system of claim 32 wherein the thirddisplay marker is responsive to the first display marker or seconddisplay marker.
 34. The system of claim 18 wherein the first portion ofthe display includes at least one first display marker and wherein thesecond portion of the display includes one second display marker andwherein the third portion of the display includes one third displaymarker, said at least one first display marker defining a first regionof interest, said at least second display marker defining a secondregion of interest and said at least third display marker defining athird region of interest wherein said first region of interest, saidsecond region of interest and said third region of interest correspondto the same location of the body.
 35. The system of claim 34 whereinsaid first region of interest, said second region of interest and saidthird region of interest include a first nodule, second nodule and thirdnodule, respectively.
 36. The system of claim 35 wherein the firstnodule, second nodule and third nodule correspond to a nodule in thebody.
 37. The system of claim 36 wherein the nodule is potentiallycancerous.
 38. The system of claim 18 wherein the interface displays aslice number identifying a CT axial scan.
 39. The system of claim 18further including a fourth portion of the display, said fourth portiondisplaying patient information.
 40. The system of claim 18 furtherincluding a fourth portion of the display, said fourth portion whenactivated displaying a magnification box for displaying an enlarged viewof a selected region.
 41. The system of claim 40 wherein themagnification box is configurable.
 42. The system of claim 40 whereinthe magnification box has a center corresponding to a location definedby a marker.
 43. The system of claim 40 wherein the magnification box isdisplayed within the first portion of the display.
 44. The system ofclaim 40 wherein the enlarged view includes a nodule in the tomographicaxial section highlighted by an outline defining the shape of thenodule.
 45. The system of claim 40 wherein a cursor may be positioned ata first location within the enlarged view and dragged to a secondlocation, the distance between the first location and second locationbeing displayed on the interface.
 46. The system of claim 18 wherein thefirst portion of a display renders an image formed from a composite ofmore than one tomographic axial section.
 47. The system of claim 18further including a fourth portion of the display, said fourth portionwhen activated displaying thick slices.
 48. The system of claim 18further including a fourth portion of the display, said fourth portionwhen activated displaying markers in said first portion, said secondportion and said third portion of the display.
 49. The system of claim18 further including a fourth portion of the display, said fourthportion when activated removing from display any markers in said firstportion, said second portion and said third portion of the display. 50.The system of claim 18 further including a navigation tool.
 51. Thesystem of claim 50 wherein the navigation tool includes identifiersgraphically corresponding to at least one tomographic axial sectiondisplaying a nodule when said tomographic axial section is rendered inthe first portion.
 52. The system of claim 51 wherein the navigationtool includes means for rendering the tomographic axial section adjacentto the section then being rendered in the first portion of the display.53. The system of claim 50 wherein the navigation tool includes anidentifier graphically corresponding the relative location of thetomographic axial section then being rendered in the first displaywithin the sequence of tomographic axial section.
 54. The system ofclaim 50 wherein the navigation tool includes means for rendering asequence of tomographic axial sections.
 55. The system of claim 51wherein the views rendered in the second portion of the display areresponsive to the particular tomographic axial section then rendered inthe first portion.
 56. The system of claim 50 wherein an identifier onthe navigator tool when selected displays the tomographic axial sectionin the first display corresponding to said identifier.
 57. The system ofclaim 18 further including a fourth portion of the display, said fourthportion when activated allowing a cursor to be positioned at a firstlocation in the first display and dragged to a second location, thedistance between the first location and second location being displayedon the interface.
 58. The system of claim 18 further including a fourthportion of the display, said fourth portion when activated displaying areport relating to images displayed in the interface.
 59. The system ofclaim 58 wherein the report includes reference coordinates correspondingto the relative location of the one or more nodules.
 60. The system ofclaim 58 wherein the report includes the radius of at least one nodule.61. The system of claim 58 wherein the report includes the calculatedvolume of at least one nodule.
 62. The system of claim 58 wherein thereport includes the relative intensity of at least one nodule.
 63. Thesystem of claim 58 wherein the report includes the percentage change involume of the size of at least one nodule over a period of time.
 64. Thesystem of claim 58 wherein the report includes the percentage change inradius of at least one nodule over a period of time.
 65. The system ofclaim 18 further including a fourth portion of the display, said fourthportion when activated displaying a histogram of intensity levels withina selected region.
 66. The system of claim 18 further including a fourthportion of a display for rendering a sequence of tomographic axialsections taken of the body, a fifth portion of the display for renderinga volumetric view of the body and corresponding to the images displayedin the fourth portion and a sixth portion of the display for rendering avolumetric view of a selected feature shown in the section then beingrendered on the fourth portion of the display.
 67. The system of claim66 further including a first navigation tool associable with the firstportion, second portion and third portion and a second navigation toolassociable with the fourth portion, fifth portion and sixth portion. 68.The system of claim 67 wherein the first navigation tool includes meansfor rendering a sequence of tomographic axial sections renderable in thefirst display.
 69. The system of claim 68 wherein the second navigationtool includes means for rendering a sequence of tomographic axialsections renderable in the fourth display.
 70. The system of claim 67further including a third navigation tool wherein said third navigationtool includes means for rendering a sequence of tomographic axialsections renderable in the first display simultaneously with therendering of a sequence of tomographic axial sections renderable in thefourth display.
 71. The system of claim 18 further including a fourthportion of the display, said fourth portion when activated displaying aschedule box for scheduling processing of image data.
 72. The system ofclaim 66 further including a navigation tool wherein said navigationtool includes means for rendering a sequence of tomographic axialsections renderable in the first display simultaneously with renderingof a sequence of tomographic axial sections renderable in the fourthdisplay.
 73. A method for rendering anatomical information obtained bytomographic scanning of a body comprising: rendering on a first portionof display a sequence of axial sections, the particular section beingrendered at any time being selectable by means of a scroll bar or scrollbuttons; rendering on a second portion of the display a volumetric viewof the body, said view including an indication of the position on thebody of the section then being rendered on the first portion of thedisplay; and rendering on a third portion of the display a view of aselected feature shown in the section then being rendered on the firstportion, said view being selectively rotatable about multiple axes.